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            Travel Agency 
            – Manager: Nikos Sirigos 
            Athens - Fira- 
            Santorini - Greece - Zip Code 84700 
            Tel: +30 22860 
            28115 - Fax: +30 22860 28116 (from USA please add 011 in 
            front) 
			
			Mob: + 30 
			6944803339 
            License 
            Number:1144E61000026101 ÁÖÌ:109293426 
            IN 
            ORDER TO MAKE YOUR PAYMENT FOR YOUR TOUR FROM OUR 
            COMPANY EASIER, WE OFFER YOU THE POSSIBILITY TO PAY BY CREDIT CARD. 
             
            TO GIVE US THE 
            LEGITIMATE RIGHT TO TRANSFER YOUR PAYMENT TO OUR BANK ACCOUNT, WE 
            KINDLY ASK YOU TO PRINT THIS AUTHORIZATION FORM,  FILL 
            IN THE FOLLOWING PERSONAL DETAILS AND SEND IT BACK TO ME VIA FAX 
            OR EMAIL. 
            
             
            We accept  visa & 
            MasterCard. We do not accept AMEX or traveler checks. Deposit can be 
            paid via bank.  
             
            THE 
            UNDERSIGNED DECLARES HEREWITH THAT NIKOS SIRIGOS, HAS 
			MY PERMISSION TO TRANSFER 30% EURO (OF THE TOTAL PRICE WE AGREED FOR 
			THE TOUR-S) FROM MY CREDIT 
            CARD FOR A TOUR THAT WILL TAKE PLACE IN ATHENS. BALANCE WILL 
            AUTOMATICALLY BE CHARGED THE DAY OF THE TOUR.  
            (date/month/year THE TOUR WILL 
            TAKE 
            PLACE)_____________________________               
            NAME OF THE 
            SHIP:___________________________________ 
            Number of 
            people:                                               
            _____________________________                
            Agreed price in 
            Euro:__________________________________ 
            
              
              
                | 
                   DATE 
                  SIGNED:  | 
                
                                                           
                  ______________________________              
                  CARD 
                  HOLDERS 
                SIGNATURE____________________________  |   
             
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